Upton A R, Longmire D
Can J Neurol Sci. 1975 Aug;2(3):153-67. doi: 10.1017/s0317167100020199.
The history of the control of epileptic disturbances by conditioning techniques is reviewed. The preliminary results of a three year trial of feedback techniques in 13 epileptic patients are presented. Thirteen epileptic patients (age 2.5 leads to 39 mean, 15.1 years) with lateralized focal discharges in the EEG were given repeated trials of feedback, the focal discharges being used to trigger auditory and somatosensory stimuli. Dosages and serum levels of medication were unchanged throughout the experimental period. The number of epileptic spikes per 15 seconds was assessed by automatic trend analysis during 20 to 30 minute control, biofeedback and post-feedback epochs. On-going EEG activity was quantified by 8 channel frequency analysis over 10 second epochs. The patients made efforts to increase and decrease the number of spike discharges with and without feedback and the results of both triggered and random auditory, somatosensory, photic and combined stimulation were compared at various intervals over a period of up to three years. A marked reduction in the number of focal discharges was noted in eight (61.5%) patients during and immediately following the sessions. Intermittent biofeedback sessions were not associated with a serial reduction in the number of focal EEG discharges. There was a reduction in the number of clinical epileptic disturbances in six patients (46%) and possible reasons for this improvement are discussed. One patient suffered an increase in focal temporal lobe discharges during triggered and random auditory stimulation whereas there was a marked reduction in the number of discharges during minimal electrical stimulation of the contralateral arm. The need for careful assessment of each patient to determine appropriate feedback stimulation is stressed. One aim of this research has been to assess the feasibility of using miniature units for continuous feedback of focal discharges in epileptic patients.
回顾了通过条件反射技术控制癫痫发作的历史。介绍了对13名癫痫患者进行为期三年的反馈技术试验的初步结果。13名脑电图显示有局灶性放电的癫痫患者（年龄2.5至39岁，平均15.1岁）接受了多次反馈试验，局灶性放电被用于触发听觉和躯体感觉刺激。在整个实验期间，药物剂量和血清水平保持不变。在20至30分钟的对照、生物反馈和反馈后阶段，通过自动趋势分析评估每15秒的癫痫棘波数量。通过对10秒时间段进行8通道频率分析来量化持续的脑电图活动。患者在有反馈和无反馈的情况下努力增加和减少棘波放电的数量，并在长达三年的不同时间段比较了触发式和随机的听觉、躯体感觉、光刺激及联合刺激的结果。在治疗期间及治疗后立即观察到8名（61.5%）患者的局灶性放电数量显著减少。间歇性生物反馈治疗与脑电图局灶性放电数量的持续减少无关。6名患者（46%）的临床癫痫发作次数减少，并讨论了这种改善的可能原因。一名患者在触发式和随机听觉刺激期间颞叶局灶性放电增加，而在对侧手臂进行最小电刺激期间放电数量显著减少。强调需要对每位患者进行仔细评估以确定合适的反馈刺激。本研究的一个目的是评估使用微型装置对癫痫患者局灶性放电进行持续反馈的可行性。
